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Robin Brown - Robin Brown ry ' p tv\I Afv\I BEI\C H Office of the City Clerk JAN 3 1700 Convention Center Drive 2023 Miami Beach, FL 33139 C!Ty F 305.673.7411 OFFICE PM- OF BFAC/� LOBBYIST REGISTRATION FORM n'CLERK Lobbyist means all persons employed or retained,whether paid or not, by a principal who seeks to encourage the passage, defeat or modification of any ordinance, resolution, action or decision of any commissioner; any action, decision, recommendation of the City Manager or any City board or committee;or any action,decision or recommendation of any City personnel during the time period of the entire decision-making process on such action, decision or recommendation that foreseeably will be heard or reviewed by the City Commission, or a City board or committee. The term specifically includes the principal as well as any employee engaged in lobbying activities. The term"Lobbyist"has specific exclusions. Please refer to City Code Chapter 2, Article VII, Division 3, entitled"Lobbyists," for additional information. Instructions: Please complete all sections of this form and submit the completed form,with the applicable fee,to the Office of the City Clerk. If you need more space to complete an answer, use a separate sheet(s) of paper. If you have nothing to report in a particular section, you must write "none" or "n/a" in that section. Any change to any information originally filed, or any additional City Commissioner or personnel who are also sought to be lobbied shall require that the lobbyist file an amendment to the registration form. The lobbyist has a continuing duty to supply information and amend the forms filed throughout.the period that the lobbying occurs. Separate registration forms shall be required for each principal represented on each specific issue. I. LOBBYIST INFORMATION: Brown Robin NAME OF LOBBYIST (Last) (First) '(Middle Name) SOV CMB Hotel Owner LLC 250 Smoke Valley Road Osterville MA 02655 LOBBYIST BUSINESS NAME AND ADDRESS (Number and Street) _ (City) (State) (Zip Code) 617-775-6789 robinbrown@spotonventures.com LOBBYIST BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS II. PRINCIPAL INFORMATION: Brown Robin NAME OF PRINCIPAL (Last) (First) (Middle Name) SOV CMB Hotel Owner LLC 250 Smoke Valley Road Osterville MA 02655 PRINCIPAL BUSINESS NAME AND ADDRESS (Number and Street) (City) (State) (Zip Code) 617-775-6789 robinbrown@spotonventures.com PRINCIPAL BUSINESS TELEPHONE NUMBER CELLULAR TELEPHONE NUMBER EMAIL ADDRESS i._ ��itb fs�t jLQIft t l• 2 4€3&'i-p((t (O a prrne'p I Cif OM corgoEflta part i-rsh p ®F @1EiO'allay c euraya3 Eg a BMW ai) Elalga( •Nialag wank/ a aom:en atio: ®patefeffIRMESIM for(Dag ape-ar ri' e,MAW eilBgt,lberlija or col tingen, coltgg3 su•mill @JCL comMli® L>° D.' item shall Qister ith the®er, as re•uir,oki by his subsection bu shall not be regu'rred to pay any :egistiation'f E9s If the principal is a Corporation, Partnership or Trust, the following information MUST be provided pursuant to City Code Section 2-482(c): • NAME OF CHIEF OFFICER,PARTNER,OR BENEFICIARY(If none,write NIA): Robin Brown-Manager • NAME OF ALL PERSONS HOLDING,DIRECTLY OR INDIRECTLY,A 5%OR MORE OWNERSHIP INTEREST IN SUCH CORPORATION,PARTNERSHIP OR TRUST(if none,write NIA): See Exhibit A Page 1 of 5 III. ISSUE TO BE LOBBIED: Describe with as much detail as is practical, including but not limited to a specific description where applicable of a pending request for proposal, invitation to bid, or public hearing number. Land use, zoning and permitting issues for the property located at 4000 Collins Avenue IV. CITY AGENCIES/INDIVIDUALS TO BE LOBBIED: Pursuant to City Code Section 2-482(a)(4), list the City Commissioner or City personnel sought to be lobbied, and whether the lobbyist has entered into any contractual relationship (paid or unpaid) with said City Commissioner or City personnel from 12 months preceding such commencement of service with the City to the present date,stating the general nature of the subject contractual relationship. Full Name of Individual and Contractual Relationship (If yes,explain) YES NO Title of Person to be Lobbied City Commission x Historic Preservation Board x Board of Adjustment x City Manager x City Staff x Building Department x Planning Board x Pursuant to City Code Section 2-482(g), every registrant shall be required to state the extent of any business, financial, familial or professional relationship, or other relationship giving rise to an appearance of an impropriety, with any current City Commissioner or City personnel who is sought to be lobbied as identified on the lobbyist registration form filed. List any Business,Financial, Familial or Professional Relationship, or other relationship giving rise to an appearance of impropriety(if none,write N/A): N/A V. DISCLOSE RATE AND AMOUNT OF LOBBYIST COMPENSATION — Be Specific. (Note that a contingency fee is prohibited pursuant to City Code Sec. 2-485,3): N/A-corporate representative Page 2 of 5 The following six(6)questions MUST be answered: 1) Pursuant to City Code Section 2-488,entitled"Prohibited Campaign Contributions By Lobbyists On Procurement Issues": _Yes XNo: Are you lobbying on a present or pending bid for goods, equipment or services, or on a present or pending award for goods,equipment or service? 2) Pursuant to City Code Section 2-490, entitled"Prohibited Campaign Contributions By Lobbyists On Real Estate Development Issues": Yes XNo: Are you lobbvinq On a pending application for a Development Agreement with the City or application for change of zoning map designation or change to the City's Future Land Use Map? 3) Pursuant to City Code Section 2-482(h), any person (except those exempt from the definition of"lobbyist" as set forth in Section 2-481)who only appears as a representative of a not-for-profit corporation or entity without special compensation or reimbursement for the appearance,whether director indirect to express support of or opposition to any item,shall register with the city clerk as required by this section,but shall not be required to pay any registration fees. _Yes X_No: Are you representing a not-for-profit corporation or entity without special compensation or reimbursement? 4) Pursuant to City Code Section 2-481, the term "lobbyist"specifically excludes the following persons: Expert witnesses who. provide only scientific,technical or other specialized information or testimony in public meetings;any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct, indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of not-far-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. _Yes XNo: Are you providing only scientific, technical or other specialized information; appearing as a representative of a neighborhood association without special compensation or reimbursement or representing a not-for-profit based organization for the purpose of requesting a grant without special compensation or reimbursement? 5) Pursuant to City Code Section 2-491(1),no campaign consultant shall lobby the City Commission for a period of 12 months following the swearing in of any elected officials)for whom the campaign consultant provided campaign consulting services Within the past election cycle.See Section 2-491 for more information. _Yes XNo: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes,please list the incumbent member(s)of the City Commission: -Yes XNo: [I'f M,Maas itlbeen less than 142 months sin th ce e electedlr`ffieiai("s1)Iwmho yo.0 prauideci campaigry ,Qnsuttrnq so.,;ices was sworn iiari 6) Pursuant to City Code Section 2-482(a)(4)a., a lobbyist who has within the past election cycle provided campaign consulting .services to an incumbent member of the City Commission(which lobbying activity is not otherwise prohibited by Code section 2-491) shall disclose such particular service on his/her lobbyist registration form and shall orally disclose such particular service before lobbying the City Commission at a public meeting. _Yes x.No: Have you provided campaign consulting services to an incumbent member of the City Commission within the past election cycle?If yes,please list the incumbent member(s)of the City Commission: Yes X No: f yes, w re you promised or did you receiue eco ornic consideration 'n exchange for cam.paiq ' orlsult nq serrvices'. - TO BE COMPLETED BY CITY CLERK'S STAFF ONLY Annual Registration fee': [ ]Yes•[ "No 'Amount Paiid$ MGR:# Date Paid. 'Lobbyist;Registration''Form received and-verified'by: _ 'F.r\cLErzN.SA L 4nortmem ierisvIsx FertiviSN14,4,yist RceistraYion•F-in'oRcvised 03-11-20.REG.doc Revised O3/11/2O2a Page 3 of 5 VI. SIGNATURES UNDER OATH: ON FEBRUARY 28 OF EACH YEAR,EACH LOBBYIST SHALL SUBMIT TO THE OFFICE OF THE CITY CLERK A SIGNED STATEMENT UNDER OATH, LISTING LOBBYING EXPENDITURES, AS WELL AS COMPENSATION RECEIVED, FOR THE PRECEDING CALENDAR YEAR WITH REGARD TO THE SPECIFIC ISSUE ON WHICH THE LOBBYIST HAS BEEN ENGAGED TO LOBBY. A STATEMENT SHALL BE FILED EVEN IF THERE HAS BEEN NO EXPENDITURE OR CO ENSATION DURI THE REPORTING PERIOD? Signature of Lobbyi . / 23 I do solemnly swear or affirm that all of the foregoing facts, statements,and disclosures in this form are true and correct, and that I have read or am familiar with the provisions contained in Chapter 2, Art. VII, Division 3, entitled "Lobbyists" of the Miami Beach City C and all reporting uirements. Signature of Lobbyi . /2023 Signature of Principal.teglefe„age_a&reZ4Zdeept.Dvesoadqp/2023 VII. NOTARY SIGNATURE AND SEAL: LOBBYIST: PRINCIPAL State of Florida State of Florida County of: Broward County of: Broward Sworn to(or affirmed) and subscribed before me, Sworn to(or affirmed)and subscribed before me, by means of 0 physical presence by means of 0 physical presence oriZ online notarization, or fir online notarization, this 23r day of January ,2023 by this 23rdday of January ,2023,by Robin Brown Robin Brown NAME OF LOBBYIST NAME OF PRINCIPAL V Produced ID MA %/Produced ID MA driver's license FORM OF IDENTIFICATION FORM OF IDENTIFICATION _Personally Known Personally Known Si nature of Notary Public ignature of Notary Public Jaylen C Ford Jaylen C Ford Name of Notary,Typed. Printed or Stamped Name of Notary,Typed,Printed or Stamped Notarized online using audio-video communication JAYLEN C FORD AVM:(NOTARY SEAL) fl. ,., , Notary Public-State of Florida (NOTARY SEAL) I I l l l l ;,E Conn dsslon N teumss a,.,ao .wvLEF1 C FORD +�`� Egi4cs on to m7! (ice ram,•�'n s Notary Pob&-Stateot Florida o��� Illlll : s Cormnkslon It N000tt ♦p Ce - EvIres on LnWr N.2775 1 The term"lobbyist"specifically excludes the following persons: ;,,; ' Expert witnesses who provide only scientific,technical or other specialized information or testimony in public meetings;any person who only appears as a representative of a neighborhood association without compensation or reimbursement for the appearance,whether direct, indirect or contingent,to express support of or opposition to any item;and any person who only appears as a representative of not-for-profit community based organization for the purpose of requesting a grant without special compensation or reimbursement for the appearance. Page 4 of 5 MIAMIBEACH City of Miami Beach,1700 Convention Center Drive,Miami Beach,Florida 33139,www.miamibeachfl.gov Office of the City Clerk Rafael E.Granada,City Clerk CityClerk@miamibeachfl.gov Tel:305.673.7411, Fax: 305.673.7254 NAME OF LOBBYIST: Robin Brown 1) LOBBYIST FEE EXPENDITURE AND COMPENSATION STATEMENT Pursuant to City Code Section 2-485(d), the City Clerk shall notify any lobbyist (or principal) who fails to file timely a Lobbyist Fee Expenditure and Compensation Statement (Statement). In addition to any other penalties that may be imposed as provided in Section 2-485.1, a fine of $50.00 a day shall be assessed for Statements filed after the due date. The City Clerk shall notify the. Miami-Dade County Commission on Ethics and Public Trust of the failure of a lobbyist (or principal) to file the Statement or pay the assessed fines after notification. Any lobbyist, who fails to file the required Statement by April 30th of each year, shall be automatically suspended from lobbying until all fines are paid, unless the fine has been appealed to the Miami-Dade County Commission on Ethics and Public Trust. I hereby acknowledge that on February 28 of each year, I shall submit to the City Clerk a signed Statement under oath listing all lobbyist expenditures, as well as compensation received, for the preceding calendar year with regard to the specific issue on which I have been engaged to lobby. 2) LOBBYIST WITHDRAWAL Once an issue I have registered to lobby has concluded or I am no longer lobbying on that issue, I shall immediately file a Notice of Withdrawal with the Office of the City Clerk. 3) ANNUAL LOBBYIST REGISTRATION FEE I understand annual registration of all lobbyists shall be required for each 12-month period commencing October 1 of each year, and the fee for such annual registration shall be $500.00 pursuant to Section 2-482 of the Miami Beach City Code. ate,X4V71.41eto if4tCieloW/ 01/23/2023 Signature of Lobbyist Date F:\CLER1$ALL\aFORMSILOBBYIST FORMS\Lobbyist Registration Form Revised 03-11-20 REO.doa Page 5 of 5 Exhibit A Disclosure of Interest: SOV CMB HOTEL OWNER LLC Property Owned by: SOV CMB HOTEL OWNER LLC 100% 250 Smoke Valley Road Osterville,MA 02655 SOV CMB HOTEL OWNER LLC Owned by: SOV CMB VENTURE LLC 100% 250 Smoke Valley Road Osterville,MA 02655 SOV CMB VENTURE LLC Owned by: SOV CMB LLC 5% 250 Smoke Valley Road Osterville,MA 02655 Highwater Hospitality,LLC 95% 10 St.James Ave. Suite 1700 Boston,MA 02116 SOV CMB LLC Owned by: Spot On Ventures LLC 100% 250 Smoke Valley Road Osterville,MA 02655 Highwater Hospitality,LLC Owned by: Samuel S.Plimpton 1% 10 St.James Ave. Suite 1700 Boston,MA 02116 Quiet Cove Capital Corp Ltd. 19.8% Paulton House, Old Mills Bristol,BS39 7SX,United Kingdom Orbex Holdings LLC 19.8% PO Box 961510 Boston,MA 02196 66988958;1 DeWitt Davenport 19.8% 20 North Main Street South Yarmouth,MA 02664 Pendo Investments II,LLC 19.8% 300 Commonwealth Avenue Boston,MA 02115 Longtail Miami LLC 19.8% 10 St.James Ave. Suite 1700 Boston,MA 02116 Spot On Ventures LLC Owned by: Robin Brown 100% 250 Smoke Valley Road Osterville,MA 02655 Quiet Cove Capital Corp Ltd Owned by: Brian Paes-Braga 100% Paulton House, Old Mills Bristol,BS39 7SX,United Kingdom Orbex Holdings LLC Owned by: Pamela Kolhberg 50% PO Box 961510 Boston MA 02196 A. Curt Greer 50% PO Box 961510 Boston MA 02196 Pendo Investments II,LLC Owned by: Thomas W.Blumenthal Trust 2008 100% Beneficiary (100%): Thomas W.Blumental 300 Commonwealth Avenue Boston,MA 02115 Longtail Miami LLC Owned by: 66988958;1 Samuel S.Plimpton 100% 10 St.James Ave/Suite 1700 Boston,MA 02116 66988958;1 M 1AM 1 BEACH " REGENED City of Miami.Beach JAN so Z023 1700 Convention Center Drive BEACH. Miami Beach, Florida 33139 OF M K www.mianiibeachfl_.gov OFFICE OF THE CITY CLERK City-Clerk's Office Tel: 305-673-7411 Fax: 305,673-7254- Office Use Only ANNUAL LOBBYIST REGISTRATION FORM Name: Robin Brown Business Name: SOV CMB Hotel Owner LLC Address: 250 Smoke.Valley Road, Osterville, MA 02655, Office Telephone Number: Cellular Telephone Number: 617-775-6789 Email Address: robinbrown@spotonventures.com If more than one lobbyist,please list: 1) n/a 2) 3) 4) 5) 6) 7). . ,Submit this form to the Office, of the City Clerk, along: with .a,check for-$500.for each lobbyist. Please make the check(s) payable'to the City of Miami Beach.; For City Clerk's Office Use Only MCR#: Amount paid: Date paid: Processed:by: Date: F:\CLER\$ALL\aFORMS\LOBBYIST FORMS\ANNUAL LOBBYIST REGISTRATION FORM reg.docx